Kelly Ann Roth, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20709 Issued in OH

Practice address

1515 Portage St NW
Suite I
North Canton, OH 44720-2290

Phone

(330) 494-0646

Fax

(330) 494-9181

NPI assigned

Aug 11, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104837111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7077 PEBBLESTONE AVE NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447206679",
            "telephone_number": "330-433-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 PORTAGE ST NW",
            "address_2": "SUITE I",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447202290",
            "telephone_number": "330-494-0646",
            "fax_number": "330-494-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "20709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla M Rose, PA-C
• Lauren E Rose, OTR/L
• Craig Ross, CCC-SLP
• Shana Ross
• Taylor Ross, LSW
• Bryan Rouse, OTR/L
• Janet M Rowe, COTA/L
• Michael G Rowell, OTR/L
• Gilbert R Rowley, MD
• Brandi L Rozeski, LPTA

• General Practice Dentistry in North Canton, OH
• Providers in North Canton, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.